Epidemiology and Infection

Evaluation of the meningitis epidemics risk model in Africa

E. C. SAVORY a1c1, L. E. CUEVAS a1, M. A. YASSIN a1, C. A. HART a2, A. M. MOLESWORTH a1 and M. C. THOMSON a3
a1 Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
a2 Department of Medical Microbiology, University of Liverpool, Liverpool, UK
a3 International Research Institute for Climate Prediction, Palisades, New York, USA

Article author query
savory ec   [PubMed][Google Scholar] 
cuevas le   [PubMed][Google Scholar] 
yassin ma   [PubMed][Google Scholar] 
hart ca   [PubMed][Google Scholar] 
molesworth am   [PubMed][Google Scholar] 
thomson mc   [PubMed][Google Scholar] 


Meningitis epidemics have a strong environmental component in Africa with the most severe epidemics occurring in the Sahelian region known as the Meningitis Belt. The objective of this study is to evaluate an ecological model based on absolute humidity and land cover type to predict the location of these epidemics. The risk model is evaluated prospectively based on epidemics occurring in Africa from January 2000 to April 2004. Seventy-one epidemics occurred during this time period affecting 22% of continental African districts. The model predicted their location with a sensitivity of 88%. The evaluation also suggests that epidemics may be extending south of the Sahel, which is consistent with environmental changes in the region. This model could be used to select priority areas for the introduction of the newly developed conjugate meningococcal vaccines. Further studies are needed to enhance our understanding of the complex relationship between meningitis epidemics and the environment.

(Accepted December 2 2005)
(Published Online February 14 2006)

c1 Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L35QA, UK. (Email: e.c.savory@liverpool.ac.uk)